May, 2000
Duties After Loss and General Provisions
Summary: The conditions of the personal auto policy are contained in parts E and F of the policy. The scope of part E is conveyed by its title – “duties after an accident or loss.” Part F, entitled “general provisions,” is a catchall for such matters as policy period and territory, subrogation rights of the insurer, cancellation provisions, etc. Separate descriptions of the two parts follow.
Topics covered:
Insured's duties after an accident or loss
General provisions
We have no duty to provide coverage under this policy unless there has been full compliance with the following duties:
A. We must be notified promptly of how, when and where the accident or loss happened. Notice should also include the names and addresses of any injured persons and of any witnesses.
Analysis
The insured's duties after an accident or loss are intended to be conditions precedent for providing coverage under the personal auto policy. In other words, the intent of the PAP has always been to require, after a loss, compliance with the duties section prior to implementing the insuring agreements. At least one state court has held, however, that unless the policy contains a specific statement requiring compliance with the duties section in order to effect coverage, failure to comply with the duties section would not allow the company to deny coverage. In response to this, the current PAP has a lead-in paragraph stating that the insurer has no duty to provide coverage unless there has been full compliance with the duties listed on the policy.
The obvious first duty after an accident or loss is that of “promptly” notifying the company of the particulars of the accident: “how, when and where” the accident occurred and the names and addresses of any persons injured in the accident or witnessing it.
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